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(Circulation. 2001;104:e134.)
© 2001 American Heart Association, Inc.

Images in Cardiovascular Medicine

Virtual Imaging for Teaching Cardiac Embryology

Jean-Marc Schleich, MD; Jean-Louis Dillenseger, PhD

From the Département de Cardiologie et Maladies Vasculaires, Hôpital de Pontchaillou (J.-M.S.), and the Laboratoire de Traitement du Signal et de l’Image, Université de Rennes (J.-L.D.), Rennes, France.

Correspondence to Jean-Marc Schleich, MD, Département de Cardiologie et Maladies Vasculaires, Hôpital de Pontchaillou, 35033 Rennes CEDEX, France. E-mail jean-marc.schleich{at}chu-rennes.fr

Knowledge of the embryology of the normal heart is essential for understanding the development of congenital cardiopathies. However, learning embryology is not an easy matter because it requires understanding the intricacy and evolution of many complex structures and functions. Classically, this evolution is usually described in textbooks by means of drawings and sketches. With these techniques, however, it is difficult to imagine the spatial and temporal links. Recent advances in computer graphics have brought about ways to illustrate these dimensions. We developed a 3D animation of the full embryogenetic process of the normal heart. A group of cardiac embryology experts composed of cardiologists, paediatrician-cardiologists, and embryologists synthesized the data contained in the main textbooks of embryology. On the basis of the resultant consensus, computer graphics were used to model 3D anatomical structures corresponding to each stage of heart development: fertilization, development of trilaminar germ disc, formation and folding of the primitive heart tube (Figure, A), morphogenesis of the heart chambers (Figure, B and C) and valves, and development of the aorta and the pulmonary artery (Figure, C). These illustrations demonstrate that virtual imaging can significantly improve the understanding of complex systems. It is now possible to understand normal heart development in 15 minutes.

View larger version (77K): [in this window] [in a new window]   Embryogenesis from days 21 to 28. A, The cardiac loop is formed. The heart tube is folded into an S-shaped dextro-ventral convexity. B, The atria are partitioned. The septum primum (in brown) grows from the inferior part of the atria to the top, leaving a foramen called the ostium primum. The septum secundum (in orange) comes from the top. The ostium primum will be closed at the end of the fifth week by an expansion of tissue coming from the endocardial cushions (in yellow). C, The conus and the truncus are partitioned. The dextrodorsal and sinistroventral conus ridges, which are isolated in the first picture, partition the conus by a helical outgrowth into 2 cavities: the subpulmonary and the subaortic coni. The truncus is partitioned from the bottom upward from aorticopulmonary swellings, leading to the formation of the aorta and pulmonary arteries.

Footnotes

The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.

Circulation encourages readers to submit cardiovascular images to the Circulation Editorial Office, St Luke’s Episcopal Hospital/Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.

This Article Extract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Schleich, J.-M. Articles by Dillenseger, J.-L. Search for Related Content PubMed PubMed Citation Articles by Schleich, J.-M. Articles by Dillenseger, J.-L. Related Collections Developmental biology Imaging Information technology Myogenesis